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South Carolina rates for HCPCS L3763

Elbow-wrist-hand orthosis (EWHO), rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $436.52 / $1,445.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $436.52 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $891.25 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $354.81 / $954.99
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $389.05 / $512.86
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $676.08 / $1,479.11
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $229.09 / $234.42
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $446.68 / $977.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $426.58 / $794.33